What Does a Workers’ Compensation Lawyer Do?

If you’re injured on the job in Pennsylvania, workers’ compensation benefits are designed to help you recover without the stress of proving who was at fault. 

In theory, the system is straightforward: you report the injury, receive medical treatment, and begin receiving benefits that cover your medical bills and a portion of your lost wages while you recover. In reality, though, the process doesn’t always go as smoothly as it should.  While injured workers face denied claims, delayed payments, and disputes over injuries, insurance companies may question the injury and require additional medical exams before approving the benefits. 

This is where a workers’ compensation lawyer can help. From filing claims and gathering medical evidence to challenging denied claims and negotiating settlements, legal guidance can make a meaningful difference in how a case unfolds. Let’s walk through how workers’ compensation works in Pennsylvania and how a lawyer can help you through the process.

Quick Answer: What Does a Workers’ Compensation Lawyer Do?

A workers’ compensation lawyer helps injured workers navigate the claims process and protect their rights under Pennsylvania law. While the workers’ compensation system is designed to provide benefits without requiring workers to prove fault, disputes and complications can still arise. A lawyer works to ensure that:

• Workers’ compensation claims are filed and handled correctly
• Deadlines for filing a claim are met
• An injured worker receives all benefits available by law, including wage loss and medical coverage

How Does Workers’ Compensation Work In Pennsylvania?

The workers’ compensation system is designed to provide financial and medical support to employees who are injured or become ill due to their job. Pennsylvania operates under a no-fault workers’ compensation system, meaning that injured workers can usually receive benefits no matter who caused the accident, as long as the injury occurred while performing job-related duties.

Most employers in Pennsylvania—with a few exceptions—are required to carry workers’ compensation insurance for their employees.

What Do Workers’ Compensation Benefits Cover?

Workers’ compensation benefits in Pennsylvania may provide several types of support benefits depending on the nature and severity of the workplace injury. These benefits may include:

• Medical treatment related to your work injury
• Wage loss payments if your injury prevents you from working or limits your earning potential
• Specific loss benefits for permanent injuries, such as loss of vision or limb function

What Happens After a Workplace Injury?

After a workplace injury, there are typically several steps in workers’ compensation claims. While each case is different, here is how the process typically works:

1. Report Your Injury: To be eligible for workers’ compensation benefits, you have to report your workplace injury within 120 days, though it’s best to report within 21 days for your best chance at recovering benefits retroactive to the first day you missed work due to your injury.
2. Seek Medical Treatment: Seek medical treatment for your injury right away. In some cases, your employer may require you to see a doctor from an approved provider list, especially during the early stages of your medical treatment. 
3. Your Employer Reports Injury To Insurance: Your employer will report your injury to their workers’ compensation insurance company after your injury is reported, and the insurer will open a claim. 
4. Insurance Company Reviews Claim: The insurance company reviews the details of your incident and your medical condition through medical records, accident reports, and statements from your employer or witnesses to approve or deny your benefits. 

If the claim is approved, workers’ compensation should begin covering medical treatment and a portion of your lost wages while you recover. And if your claim is denied or disputed, the process quickly becomes more complicated. 

How Can a Workers' Compensation Lawyer Help Me?

After a workplace injury, many workers aren’t sure what role a lawyer actually plays in the workers’ compensation process. While some claims move forward without major issues, others involve disputes with insurance companies, questions about medical treatment, or challenges related to benefits and returning to work. 

A workers’ compensation lawyer helps injured workers navigate these situations by managing the legal aspects of the claim, advocating for their rights, and ensuring the workers’ compensation system is applied fairly.

Below are several ways a workers’ compensation lawyer may assist injured workers throughout the claims process in Pennsylvania.

Help You File a Workers’ Compensation Claim

One of the first ways a workers’ compensation lawyer can assist injured workers is by helping ensure the claim is filed properly. While reporting a workplace injury may seem simple, the workers’ compensation system in Pennsylvania involves specific procedures, documentation requirements, and reporting deadlines that must be followed carefully.

A workers’ compensation lawyer ensures the injury is reported accurately, that all required forms are completed correctly, and that important deadlines are met.

Investigate Your Workplace Accident

In some cases, the circumstances surrounding a workplace injury may not be immediately clear. Employers or insurance companies may question how the accident happened or whether the injury occurred while performing job-related duties.

A workers’ compensation lawyer may conduct an investigation into the accident to better understand what occurred and gather evidence that supports the worker’s claim. This may involve reviewing workplace safety records, examining accident reports, speaking with witnesses, or analyzing photographs and other documentation from the job site.

An investigation can be especially important in cases involving construction accidents, equipment malfunctions, industrial incidents, or other serious workplace hazards. By carefully reviewing the facts surrounding the accident, a lawyer can help strengthen the worker’s claim and address questions raised by the insurance company.

Collect Medical Evidence To Support Your Claim

Insurance companies often rely heavily on medical records to determine whether an injury is work-related, what treatment is necessary, and whether a worker is able to return to work.

A workers’ compensation lawyer may help coordinate medical documentation to ensure the full extent of the injury is clearly recorded. This may mean gathering medical records, consulting with healthcare providers, and obtaining expert medical opinions when necessary.

Protect You During Independent Medical Exams (IMEs)

Insurance companies sometimes require injured workers to attend an Independent Medical Examination (IME). These exams are typically performed by a doctor selected by the insurance company to evaluate the worker’s condition.

Because these examinations can significantly affect the outcome of a claim, it’s best to have legal guidance to understand what to expect and review the results to challenge any conclusions that may not accurately reflect your medical condition.

Challenge Denied Workers’ Compensation Claims

A denied claim does not necessarily mean that a worker is not entitled to benefits. In Pennsylvania, injured workers have the right to challenge claim denials through the workers’ compensation system.

A workers’ compensation lawyer can help review the reason for the denial and determine what steps may be necessary to move forward to build a strong case.

Negotiate Workers’ Compensation Settlements

Some workers’ compensation cases may eventually be resolved through a lump-sum settlement, which provides a one-time payment in exchange for closing the claim. A workers’ compensation lawyer evaluates settlement offers to determine whether it fairly reflects the workers’ injury, expected recovery, and future medical needs. 

Represents You In Workers’ Compensation Hearings

If a dispute cannot be resolved through the insurance company, the case may be brought before a workers’ compensation judge. 

During a hearing, both sides may present evidence, medical documentation, and witness testimony related to the injury and the benefits being requested. A workers’ compensation lawyer can represent the injured worker during these proceedings, helping ensure that evidence is properly presented and that the worker’s case is clearly explained.

Workers’ compensation in Pennsylvania is intended to provide injured employees with the support they need after a workplace accident, but as many workers discover, the process doesn’t always unfold the way it should.

From helping file claims and gathering medical evidence to challenging denied benefits and evaluating settlement offers, a workers’ compensation lawyer ensures that injured workers are treated fairly throughout the entire claims process, no matter how simple or complex your case may be.

For more than 40 years, Edgar Snyder & Associates has helped injured workers across Pennsylvania navigate complex workers’ comp claims and fight for the compensation they are entitled to under the law. If you’ve been hurt on the job and have questions about your rights or your benefits, our team is here to help. 

Contact Edgar Snyder & Associates today for a free case review to discuss your situation and learn more about your options.